Can You Apply for a Medicare Supplement Insurance Plan After Your Open Enrollment Period?
When should I enroll in a Medicare Supplement insurance plan?
Medicare Supplement insurance plans help cover out-of-pocket costs, such as coinsurance, copayments and deductibles, that Medicare (Part A and Part B) doesn’t pay. The best time to buy a Medicare Supplement insurance plan is typically during the Medicare Supplement Open Enrollment period. During this Open Enrollment period, you cannot be subjected to medical underwriting, where insurance companies could use a pre-existing health condition* as a reason to deny you coverage or charge you more for coverage.
The Medicare Supplement Open Enrollment period lasts for 6 months and begins on the first day of the month in which you’re both
- 65 or older
- Enrolled in Medicare Part B
- Some states have additional Open Enrollment Periods including those for people under age 65.
What are guaranteed-issue rights?
Some situations may provide you with guaranteed-issue rights, where insurance companies cannot refuse you coverage or charge you more for a pre-existing condition* even outside of Open Enrollment. Situations that could result in guaranteed-issue rights are
- Your Medicare Supplement insurance company goes bankrupt and you lose your coverage
- Your Medicare Supplement insurance plan misled you
- Your Medicare Advantage plan stops giving care in your area or you move out of your plan’s service area and you join Medicare
- You have an employer group health plan or union coverage that is ending
- You have Medicare SELECT and you move out of the policy’s service area
- You joined a Medicare Advantage plan and decide to switch to Medicare
- You dropped your Medicare Supplement insurance plan to enroll in a Medicare Advantage plan, and you want to switch back to Medicare less than a year later
Losing your health-care coverage may give you a guaranteed-issue right to buy a Medicare Supplement (Medigap) insurance plan. Keep documentation, such as letters, emails and notices of your termination of coverage to send with your Medigap application to prove that you have guaranteed issue right.
When will I be subjected to medical underwriting?
Insurance companies may still sell you a Medicare Supplement insurance plan after your Open Enrollment period ends and you don’t have guaranteed-issue rights, but you may have to meet medical underwriting requirements. You may be asked questions about your health conditions, and either pay a higher premium or be denied coverage based on pre-existing conditions*.
What does a Medicare Supplement insurance plan cover?
Medicare Supplement insurance plans are standardized, and in most states they’re labeled A through N (plans E, H, I, and J are no longer sold). These plans may cover a range of health-care costs, such as Medicare Part A coinsurance, blood, skilled nursing facility care coinsurance, Part A and Part B deductible, and foreign travel emergencies up to plan limits.
While all Medicare Supplement insurance plans cover Medicare Part A coinsurance at 100%, the rest of the benefits vary among plans. For example, Medicare Part A out-of-pocket costs include a $1,340 deductible for each benefit period and a $335 coinsurance per day of hospitalization after 60 days for each benefit period (in 2018). Beyond Part A coinsurance, not all Medicare Supplement insurance plans cover all benefits at the same percentage.
Keep in mind that Medicare Supplement insurance plans only work with Original Medicare. You can’t use these plans to pay for Medicare Advantage costs.
*Pre-existing conditions are generally health conditions that existed before the start of a policy. They may limit coverage, be excluded from coverage, or even prevent you from being approved for a policy; however, the exact definition and relevant limitations or exclusions of coverage will vary with each plan, so check a specific plan’s official plan documents to understand how that plan handles pre-existing conditions.
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